The Promises and Challenges of the Use of Genomics in the Prescription of Exercise for Hypertension: The 2013 Update
Garrett I. Ash,
John D. Eicher,
Linda S. Pescatello.
Hypertension is a major global public health problem, resulting in over 7.6 million deaths per year (13.5% of
the total), more than any other cardiovascular disease risk factor. Exercise decreases blood pressure (BP) 5-7 mmHg
among those with hypertension. Thus, the American College of Sports Medicine recommends the exercise prescription
(ExRx) of 30 min or more of moderate intensity, aerobic activity on most days of the week to lower BP. Yet, there is
considerable individual variability in the BP response to exercise due to genetic and environmental factors that are poorly
understood. We and others have shown there is a genetic component to the BP response to exercise accounting for a
significant proportion of this variability. However, identification of specific genetic variants accounting for this variability
is a significant challenge. This review describes new work on candidate gene and BP association studies. It also describes
other important emerging work in genome wide association studies, next generation sequencing, epigenetics, and gene
expression regulation, and how this work may have future relevance to ExRx for hypertension. The ultimate goal of our
research is to use genetic information to personalize ExRx to optimize the effectiveness of exercise as a therapeutic
modality for the prevention, treatment, and control of hypertension. Because of the complexities surrounding work in
exercise genomics, the future use of genomics in ExRx for hypertension still remains a vision of the future rather than a
reality of the present.
Keywords: Blood pressure, genetics, physical activity, polymorphisms, pre-hypertension.
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